The Treatment Process

Consultation

The IMRT/IGRT treatment process generally consists of several steps including consultation, positioning, imaging, treatment planning, plan verification and treatment delivery. At our center you will find a dedicated team of medical professionals that will work with you every step of the way.

First, you will meet with Dr. Noah Taylor, your Radiation Oncologist, who will review your medical history, pathology reports and pertinent medical information to determine the most successful course of treatment.

Once a course of treatment has been determined, most patients will be scheduled for a CT scan planning appointment prior to the start of treatment.

In a treatment preparation session prior to the actual CT scan, a special molded device that assists patients in maintaining the same position each treatment is created. For most cancer sites, this consists of a formed cast that is used only while patients are actually receiving treatment. Colored, semi-permanent ink may be used to mark the skin. This mark assists in positioning patients for treatment by aligning the radiation equipment with the targeted area. A special non-contrast CT scan in the treatment position is taken to properly map the target area and to use as a reference image for each treatment. This session usually takes between 30 to 60 minutes. There is no preparation for this appointment.

Following the CT scan, the radiotherapy treatment planning process usually requires several days and does not require your presence. Therefore, your appointment for the first treatment will be approximately one week after the CT scan.

Treatment Planning

Using the information gathered during positioning and imaging, the Radiation Oncologist, Dr. Taylor, Radiation Physicist and Radiation Dosimetrist (a person specially trained to calculate and plan radiation doses) work together to deign the most effective IMRT treatment plan for your situation. As part of the treatment planning, your medical team conducts extensive quality assurance testing with the treatment equipment to ensure the planned treatment can be accurately and easily carried out.

Treatment Delivery

The first IMRT/IGRT treatment session is usually longer than subsequent treatments so that additional X-ray films and checks can be performed. A typical treatment session lasts about 15 minutes.

In the treatment room, patients are positioned on the treatment table using the specially molded device. The radiation therapist uses the marks on the skin or mask to assist in accurately locating the treatment area.

The radiation therapist leaves the treatment room and remotely controls a digital On-Board Imager device to fine tune the patient's position and move the treatment couch into final position. The On-Board Imager rotates around the patient to take digital images of the targeted area. Usually two or more images are taken from different angles. A complete rotation of the machine may be used to generate a three-dimensional image. These images are then used to guide the final adjustments of the treatment couch.

Although patients are alone in the treatment room, they can be seen on a television screen stationed at the control panel. The therapist can communicate with patients through an intercom. Patients do not see or hear the radiation nor experience any type of discomfort or feeling.

Radiation therapy usually is given five days a week for approximately 6 to 8 weeks depending on the treatment plan. When radiation is used for palliative care, the course of treatment lasts for two to

three weeks. For each radiation therapy session, the patient is in the treatment room for about 15 minutes. These types of schedules, which use small amounts of daily radiation rather than a few large doses, assist in protecting normal body tissues in the treatment area. Weekend rest breaks allow normal cells to recover. The total dose of radiation and the number of treatments a patient requires depends on the size and location of the cancer, the type of tumor, the patient’s general health and other pertinent factors.

Follow-up Care

When your course of treatment is completed, you will have a series of follow-up visits in which your doctor will monitor your condition and the effects of the treatment. Your doctor may require blood tests, X-rays, and/or scans at these appointments. Discuss with your doctor how to stay healthy after treatment. Inquire about nutrition, exercise, and other environmental changes that could help you maintain a healthy lifestyle. Equally as important, find out about support groups for cancer patients and survivors, so that you can connect with others who have had similar experiences.